Provider Demographics
NPI:1851056584
Name:CATHEY, DANIELLE ALYCE (LAC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ALYCE
Last Name:CATHEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4597
Mailing Address - Country:US
Mailing Address - Phone:303-436-5711
Mailing Address - Fax:303-602-4560
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4597
Practice Address - Country:US
Practice Address - Phone:303-436-5711
Practice Address - Fax:303-602-4560
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001907101YA0400X
COLPC.0017777101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
COACD.0001907OtherCOLORADO DEPARTMENT OF REGULATORY AGENCIES
COLPCC.0017875OtherCOLORADO DEPARTMENT OF REGULATORY AGENCIES